herbal remedies effects on cardiovascular and respiratory diseases

Published:

This essay has been submitted by a student. This is not an example of the work written by our professional essay writers.

Purpose: Herbal remedies have been found to be effective throughout South and East Asia for treating cardiovascular and respiratory diseases.

Method:

Scope: July 2001

Conclusion:

Introduction

Cardiovascular and respiratory diseases have been recorded as problematic in human society for hundreds of years. Successful treatment of these diseases using plant/herbal remedies is controversial. Plant leaves, roots, and blossoms have been harvested for use in the treatment of a variety of ailments since biblical times. Studies have been conducted worldwide, documented and published. Leading in the use of plant treatment for diseases are China and Japan. Herbalists from these countries take their findings, treatments, and successes seriously. Experimental studies in humans tend to prove that herbal remedies may be found to be effective throughout South and East Asia for treating cardiovascular and respiratory diseases.

Background

Traditional, folk, or botanical medicine, based on the use of plants and plant extracts, is called Herbalism. Herbal medicine may be extended to include fungal, bee products, minerals, and shells. Over 100 compounds used in pharmaceutical medicine are derived from plant sources or herbs.

Phenols and tannins are an important part of aromatic plant substances. Alkaloids are another plant substance which provides protection for the plants from microorganisms, insects, and herbivores. This is important for the plants very existence for hundreds of years. Using herbs and spices to season food is a common practice throughout the world. These same herbs and spices also yield useful medicinal compounds.

Medicinal herbs were found in the personal effects of Otzi the Iceman. He was found in the Swiss Alps and it was determined that he had been frozen for over 5,300 years. Parasites were found in his intestines and the herbs appear to have been used to treat them.

In the European Union (EU), herbal medicines are regulated under the European Directive on Traditional Herbal Medicinal Products. In the United States, herbal remedies are regulated as dietary supplements by the Food and Drug Administration (FDA). Just as in prescription drugs, herbs with inappropriate formulation or lack of understanding of plant and drug interactions can lead to adverse reactions and effects.

Due to over-collection and deforestation, several hundred plants are at risk of extinction. This threatens the discovery of future cures for disease. Among those in danger of extinction are yew trees and half of the magnolias used in Chinese medicine for thousand of years to fight cancer, dementia, and heart disease. Beneficial health care from plant based medicines have been reported in many health magazines.

Chinese medicine advanced in the Middle Ages. Herbs, plants, and minerals were categorized according to their pharmaceutical uses. Many of the mechanisms of these herbs and plants were not understood, but the results were valued thus the recordings that

have been handed down to a variety cultures. Chinese writers described general principles and their applications to health and healing. Compounds from mushrooms have been used to stimulate the immune system and promote health. Certain kinds of mushrooms, plants, and herbs have been effective for cardiovascular and respiratory diseases. They are responsible for maintaining and restoring circulation and body balance. Fortunately, they have few non-favorable side effects.

Discussion

Clinical trials have investigated the effects of flaxseed-derived products on blood lipids. Cardiovascular disease is the leading cause of mortality worldwide. Trials have shown the cardiovascular protective effects of various foods and dietary factors, such as nuts, fish, plant sterols, soy protein and isoflavones.(1/288) Flaxseed, an edible oil seed/grain and one of the oldest arable crops, has been acknowledged as a functional food and gained much attention because of its unique nutrient components and effect on the prevention of cardiovascular disease. Flaxseed is an essential source of dietary fiber.(1/288) Flaxseed lignans are shown to have cholesterol-lowering effect and could regress the atherosclerotic process.(1/288) Interventions, whole or ground flaxseed, lignan supplement, and flaxseed oil were conducted in so-called healthy individuals; however, in many cases these individuals had elevated lipid concentrations. Flaxseed oil with lignans contains high concentrations of omega-6 fatty acids, and omega-3 fatty acid alpha-linolenic acid. These essential fatty acids support the glandular, cardiovascular, and structural systems. Studies were categorized according to the baseline lipid concentrations.(1/289) The benefits were found to be that flaxseed aids in the construction of healthy cell walls, keeps saturated fats mobile in the blood stream, maintains already-normal stickiness of blood platelets, plays a vital role in the production of prostaglandins, maintains nerves, helps maintain cholesterol levels already in the normal range, supports the kidneys, provides beneficial phytoestrogens, and stimulates immune activity.

For thousands of years in Japan, plants and herbs have shown a positive role in maintaining human health and the quality of life.(2/672) Pneumonia ranks as the fourth leading cause of death in Japan. This is happening despite the development of modern medical prescription drugs. Herbs contributing to the affect of clear respiratory health are fenugreek, thyme, stinging nettle, and horseradish. Tea is also an important consideration in the treatment of respiratory illnesses.

Fenugreek seed has been used as a nutritional support for the respiratory system. This herb contains mucilaginous compounds, which are gel-like substances known for their ability to help soothe irritated tissues. Fenugreek also encourages thinner mucous, which can flush the toxins out of sinus cavities. It is also an excellent source of trace amounts for a few important minerals. This herb is combined with the herb thyme which has antiseptic properties and helps to strengthen the thymus gland as part of the immune response to infection. Thyme is also known to support respiratory health, especially in the bronchial region and throat. Fenugreek benefits support the respiratory system, help keep the mucus thin, and soothe irritated respiratory tissue.

Stinging nettle provides well-known support against seasonal airborne substances which affects the respiratory system. Stinging nettle benefits provide nutrients that support the respiratory system in its battle against inhaled irritants, pollutants, and toxins, provide antioxidant drinks to help stabilize mast cells, support the body's efforts to maintain mucous membrane health, support free breathing, and may help reduce unpleasant symptoms associated with irritants.

Horseradish has a stimulating effect on the respiratory system, which you can easily discover for yourself by eating a small amount of the freshly graded herb. This herb is often combined with fenugreek which helps balance the natural eliminative functions of the respiratory system. Horseradish benefits help soothe irritated tissues, encourage the entire respiratory tract to gently cleanse itself, and assist the body in neutralizing allergens by nutritional means.

The main constituents of green tea are tea catechins. They have been noticed because of their antiviral activities. Catechins are strong antioxidants. Minerals and vitamins in the tea leaves also increase antioxidant potential.(3/79) Tea catechins show agents that act against a variety of respiratory infections. Smoking is a risk factor for pneumonia; however, green tea consumption could minimize advancement.

Black tea and oolong tea intake have been assessed in a variety of ways. Following assessments, interest about preventative effects of green tea consumption on stroke is growing. Through investigations the preventative effects of green tea extract on cardiovascular disease is prevalent.(4/1030) Association between consumption of green tea and death from cardiovascular disease has indicated lower mortality from total stroke and total cardiovascular disease.(4/1030) Antioxidant activity derived from green tea is thought to be the event that inhibits the progression from these diseases. Green tea is the most widely analyzed. Answering the question as to why other types of teas have not been fully investigated, green tea and roasted tea are the most commonly consumed teas in Japan. Consequently, consumption of Japanese tea (green and roasted) is inversely associated with incidence of stroke and heart attacks. Green tea and roast tea are credited with similar effects on these diseases. Black tea and oolong tea are considered non-Japanese tea and have not been as extensively studied as to the effects on cardiovascular and respiratory diseases.

Roasted tea is simply made by roasting green tea leaves. Black tea leaves are the tender new leaves and buds picked from the top of the plant and then processed with fermentation, surprisingly, they are from the same tea plant, Camellia Sinensis. Green tea is the same leaves and buds as black tea, however, they are steamed and not fermented.

The economic and social aspects of drinking tea is part of many people's daily routine, following many years of consumption, evaluations as therapeutic aid in many illnesses is being assessed.(3/79) Non-fermentation of green tea is the reason for it to contain more catechins. Water is the number one liquid consumed in the world, and tea is the second. Green tea, according to traditional Chinese medicine may counteract the risk of cardiovascular disease. Biomarkers of oxidative stress status, provide strong evidence that green tea polyphenols may play a role in the risk and pathogenesis of several chronic diseases, especially cardiovascular disease.(3/80)

Life style factors and tea preparation may have a relevant effect on the benefits of health and preventative treatment of chronic diseases. Green tea, because of the way it is processed, has a complex composition and the mineral presence is of importance to all teas. Green tea leaves contain three main components which act upon human health: caffeine, essential oils and especially polyphenolic compounds.(3/83) Foliar application of Se-enriched fertilizers increased the antioxidant activity of selenium-enriched green tea as well as the polyphenols.(3/80) Cardiovascular diseases are the major causes of death worldwide.(5/373S) Emerging areas of significant research activities on green tea catechins include the effects on cardiovascular health. Green tea is considered a health-promoting beverage containing food components useful for the maintenance of cardiovascular and metabolic health. Green tea may reduce blood pressure. Chinese people, by drinking several cups of tea a day for one year, significantly reduced their hypertension.(3/88)

Japanese adults who consume five or more cups of tea per day were found to significantly reduce mortality. Among cardiovascular disease the strongest reduction in mortality was for stroke.(5/375S) Beneficial effects of green tea on cardiovascular disease mortality increased with increasing consumption. One or more cups of green tea a day has been found to reduce the risk of subarachnoid hemorrhage.(5/376S) Coronary atherosclerosis showed a reduction following green tea consumption of two to three cups per day by 50% and 60% for those consuming four or more cups per day.(5/376S)

Coronary artery disease and oxidative stress can be reversed with the consumption of black tea. In test results, both short and long-term, tea consumption improved flow-mediated dilation of the brachial artery, while consumption of water had no effect.(6/151) Black tea consumption improves brachial artery flow and dilation in coronary heart patients. Caffeinated tea showed short-term beneficial results while caffeine alone had no short-term effect. Other caffeinated beverages failed to demonstrate health benefits similar to those benefits from black tea.(6/155)

Stroke can have a profound influence on individuals and their families. Cigarette smoking, hypertension and diabetes are risk factors and preventative approaches have shown impact on the disease as well as the cost involved. A daily intake of black and green tea catechin extract protects the penumbra from irreversible damage due to cerebral ischemia and neurological deficits.(7/1787) Effect as to specific green or black tea or to Asian or non-Asian populations did not appear to influence the overall findings.(7/1788)

Tea consumption, for reducing the risk of ischemic stroke, shows a significant decrease in occurrence. The alterations in platelets sensitivity and platelets-vessel wall interaction are associated with a development of cardiovascular events.(8/12) Tea catechins may be pro-oxidant and create free radical scavenging mechanisms that create antioxidant capacity. Catechins prevent vascular inflammation that plays a critical role in the progression of atherosclerotic lesions and inhibit proliferation of vascular smooth muscle cells by interfering with vascular cell growth factors involved in atherogenesis.(8/1) It is estimated worldwide that 5 million people die from stroke annually and risk reduction is the largest by drinking one to two cups of green or oolong tea daily.(7/2480) The protective effect of tea is supported by a growing body of experimental studies. Tea drinking may protect against ischemic stroke by inhibiting the process of atherosclerosis in the cerebral arteries and internal carotid arteries.(7/2483)

The heart benefits from green tea have been in evidence in many studies. It is used widely and in high doses for centuries as a health tonic in many societies.(9/591) In a study of 40,000 Japanese adults, it was found that green tea consumption was inversely associated with cardiovascular disease mortality. Women who consumed five or more cups per day had a 31 percent lower risk of dying from cardiovascular disease. Participants who consumed five or more cups per day had a reduced incidence of stroke.(9/592)

Many physicians in China believe that herb plants are effective for acute bronchitis. Herbs for various symptoms or causes are combined in set quantities as a basic prescription to treat acute bronchitis. Their belief is that natural medicinal herbs are a potential drug resource. Some of the medicinal herbs used to treat bronchitis are skull cap root, honeysuckle flower, weeping forsythia, licorice root, rhododendron leaf, hemsley rockvine root, mulberry bark and pepperweed seed. Chinese clinicians and patients have widespread belief that Chinese herbs are effective in improving signs and symptoms of acute bronchitis. These herbal prescriptions have been used for generations and have basically been proven effective.

The development of herbal interventions for asthma and bronchial inflammation shows investigating studies that are aimed at proving the safety of herbal products. Herbal formulas suggest there is potential for the development of promising herbal remedies in westernized countries. Herbal formulas constituents produce synergistic effects and reduce possible side effects of prescription drugs.

Asthma affects millions of people worldwide. Its increasing prevalence, the absence of curative treatments and concern about side effects from long term use of asthma drugs have prompted interest in complementary and alternative therapies such as Traditional Chinese medicinal herbs. Herbal formulas used in therapies report improvement in lung function with herbal formulas and found them to be safe and well tolerated. Attributed to herbal success were the mechanisms of anti-inflammatory effect, inhibition of smooth-muscle contraction in the airway and modulation of immune system responses.

The increase in allergic diseases is a significant health problem. Curative therapies for these diseases have not been encouraged in westernized countries. Alternative and complementary medicines are needed for allergic conditions, especially in children who have been on conventional drugs such as corticosteroids. United States government agencies have been stimulated to provide support and guidance for a scientific herbal investigation and presents a promising insight in Chinese herbal remedies for asthma and food allergies.(10/1)

Allergy sufferers have many concerns about prescription medicine side effects. Curative therapies such as herbal remedies have advanced increasingly as complementary and alternative medicines.

Traditional Chinese medicine is a major leading therapy base in one of the oldest practices in the world. It has played an important role in preventing and treating diseases in China and other Asian countries for centuries where it is still used as a monotherapy and is integrated with prescription medicine.(10/1)

Herbal remedies are an alternative therapy for asthma and food allergy. Alternative therapy is used to counteract the corticosteroids used for asthma treatment. Corticosteroids, with prolonged use, cause serious systemic side effects which have particularly far-reaching consequences especially for children.(10/2)

An extract from sophora root has been used in the management of asthma. A dose equal to 4 grams of dried sophora root over a 27 month period showed that the use of inhaled corticosteroid and beta-agonist were reduced or eliminated.(10/5) The root appears to be safe and may be an effective alternative treatment for chronic asthma.

The chronic nature of asthma and its prevalence has increased by close to 50% in the past few decades. Westernized countries (Europe, United States, Canada, and Australia) are not escaping from this increase and concern is mounting over the effective management of this disease. These countries are also seeking preventative and curative therapy with alternative and complementary medicine.

Traditional Chinese medicine has a long history of human use in the United States. In the United States it is mainly provided by licensed practitioners and is seen to be having an increasing role in the health care system. Traditional Chinese medicine, while being widely used in the United States, has not yet been established as mainstream medicine. In China and other Asian countries herbs are commonly used, however, in the United States herbs are viewed as dietary supplements. This information, it should be noted, can be found in publications from magazines, articles, pamphlets and newspapers. They come from countries such as Japan, India, Latin America, Hawaii, Westernized countries and Korea. Practices may differ because of the derivatives that Korea and Japan use.

Japanese studies and adaption of Traditional Chinese medicine became known as "Kampo". The roots of Kampo medicine extend back to China's Han Dynasty and are highly respected. Complementary and alternative medicine, like Kampo, is what people are pursuing for their health and well being. Diverse medical and health care systems, practices and products that are not considered part of conventional medicine are being pursued. Conventional medicine is medicine practiced by medical doctors, doctors of osteopathy and allied health professionals. Conventional medicine and alternative medicine have boundaries but they may eventually overcome obstacles and become widely accepted. Working together will combine treatments as long as the practice is safe and effective.

Chinese diagnostics include pulse-reading which can be applied to the progression of cardiovascular and respiratory diseases. Palpitations of a patient's radial artery (pulse) told early herbal practitioners many things about that patient.

Standardized ingredients in herbal pills sometimes are not found as brands and companies reformulate, remix and can otherwise alter their products. Traditional Chinese treatments are cheaper than Western methods which require expensive equipment and medicines still under patent. Many Japanese physicians practice "Kampo", however, "Kampo" practitioners adopted standardization and regulations that are absent in Traditional Chinese medicine.

Practitioners of Traditional Chinese medicine report the effectiveness of individually tailored combinations of Chinese-grown herbs for stroke treatment in programs with a history of thousands of years.(11/34) It has been noted that combinations of herbs rather than one herb treatment is what has been successful in treatment of stroke patients. Possible remedies for reducing brain infarct size soon after a cerebrovascular event is Hypericum. This is used clinically in a wide range of acute situations to reduce or reverse traumatic damage to peripheral nerves.(11/34) Common complications from stroke are skin infections, pressure sores, urinary track infections and pneumonia. Herbal interventions used to relieve these ailments are aloe vera, comfrey, calendula and hypericum. Individual herbs, herbal mixtures and certain treatments appear promising for primary treatment of cerebral infarction and for complications of stroke. Western medicine sometimes stand in the way of letting herbal treatment play a role in stroke prevention, treatment and rehabilitation.(11/36)

In the United States about one in four persons taking prescription medication also take a dietary supplement.(12/73) Negative effects are most pronounced with anticoagulants, cardiovascular medications and hypoglycemics. The most named herb documented is St. John's Wort. This herb is one that one may think seriously about not ingesting. Of all supplements used by patients who have cardiac disease, St. John's Wort used to treat mood disorders, is associated with having the most negative results.(12/75)

Cardiovascular diseases are declining due to longer life expectancy mainly attributed to improved medical treatment and primary prevention treatment. The reduction of blood pressure and cholesterol has been attributed to several forms of alternative medicines such as herbal remedies. Patients with cardiovascular disease may resort to alternative sources for prevention and treatment. Because of their chronic heart disease they are willing to work with their practitioners and express their desire to try antioxidants with other dietary supplements combined with the ever popular fish oil.

A healthy cardiovascular system is essential for maintaining well-being and vitality. Threatening foes, cholesterol and triglycerides, contribute to coronary calcification which narrows and slows or stops blood flow causing heart disease and death.

The threat of heart disease can be reduced by reducing risk factors such as smoking, high blood pressure, high cholesterol, obesity, physical inactivity and diabetes, lifestyle modification, rethinking nutrition and implementing a systematic herbal plan. Red rice has been known to contribute heart healthy benefits. Red yeast rice, a product of rice fermented with a special yeast, has been used in China for a medicinal substance. Red yeast, it has been found, contains substances that are similar to prescription medications that lower cholesterol. Red yeast contains an enzyme that reduces total cholesterol and it may help lower the risk of heart disease.

High blood cholesterol, a genetic predisposition, accounts for high cholesterol in some individuals but for the majority, lifestyle and eating habits are key risk factors. A diet in plant-based food gives cardiovascular benefits. These benefits may be due to plant sterols or phytosterols. Phytosterols are essential components of plant cell membranes and are found in wheat germ, wheat bran, corn oil, peanuts, macadamia nuts, canola oil and olive oil.

Hawthorn is a well-known heart-healthy herb. Hawthorn, a member of the rose family, has been traditionally used for various heart concerns. The leaves, flowers and berries are used and contains flavonoids that are thought to be most responsible for hawthorn's beneficial effects on the heart. This herb helps dilate blood vessels, improve blood flow and supports a healthy heart rate. The antioxidant of hawthorn contributes to healthy blood pressure and cholesterol levels. The heart pumps blood containing oxygen and nutrients through vessels to all the organs in the body and in turn removes carbon dioxide and waste products.

Hawthorn is traditionally used for the circulatory system. It strengthens contractions in the heart and increases the output volume of each contraction. Chronic heart failure, where the heart is no longer able to pump enough blood throughout the body has benefited from hawthorn berry and has shown no ill effects. Cardiovascular tissues endure a great exposure to oxygen and free radicals. Free radicals enter the blood from the air we breathe and foods we eat. Diets need to be high with antioxidants such as hawthorn and garlic. This will ensure good health and longevity. There are no known food interactions with either hawthorn or garlic.

The fresh garlic clove makes up the supplement that is used for medicine. Garlic is used for many conditions related to the heart and blood system which include high blood pressure, high cholesterol, coronary heart disease, heart attack and hardening of the arteries (atherosclerosis). Some of these uses are supported by science. Garlic is effective in slowing the development of atherosclerosis and seems to be able to reduce blood pressure. Other uses include treatment of sinus congestion, asthma, bronchitis, shortness of breath and maintaining healthy liver functions. Evidence is that fresh garlic may be more than a flavoring for food. The stress is to use fresh garlic not aged garlic for cooking as it can kill certain bacteria such as E.coli, antibiotic-resistant staphylococcus aureus and salmonella enteritidis in many laboratory testings.

Garlic is approved in herbal medicinal products and food stuff in the European Union. In Germany herbal medicinal products are not considered alternative or complementary products but as regular drugs. Germany has the biggest market for garlic products followed by the United Kingdom.(13/732S-34S) Herbal products, such as garlic, are regulated by the same rules as all other medicinal products if they are therapeutic.

Garlic is used in the support of dietary measures for treating hyperlipidemia and atherosclerosis. Traditional Chinese medicine herbs and formulas are now attracting significant interest in the west with methodologies and clinical trial protocols.(10/7) Nutritional factors such as antioxidants and long term dietary patterns high in omega-3 fatty acids may reduce chronic inflammation and the risk of vascular events, ischemic damage and neuronal damage.(11/32)

Ginseng is one of the most widely used herbal medicines and has a wide range of therapeutic and pharmacological applications. "Ginseng" comes from a Chinese word which means "man-herb." The root is the most commonly consumed part of the plant. Ginseng is considered "all healing" which is of the traditional belief that ginseng has properties to heal all aspects of the body.(14/1) Because of its wide range of therapeutic and pharmacological uses, ginseng has gained much attention in its mechanics and applications toward cardiovascular treatment.(14/2) Ginseng fights against free radical damage and acts as an antioxidant.

Grape seeds have been among the most noted therapeutic properties available as a popular herbal supplement for cardiovascular disease. The main characteristic of grape seed is polyphenols which are condensed to tannins. They are the main antioxidant components in grape seed extracts.(15/2)

Antioxidant botanical ingredients, which include traditional herbal medicines and dietary supplements, have been put through a barrage of investigations. Cardiovascular illness includes damaging effects from superoxide, hydrogen peroxide, singlet oxygen, peroxyl radicals, hydroxyl radicals and peroxynitrite. Herbal antioxidants have been found to protect against these diseases by contributing to the total antioxidant defense system of the human body.(15/1) The effect of herbal antioxidants has been positive. Epidemiological studies have shown that intake of a group of herbal antioxidants is inversely related to mortality from coronary heart disease and to the incidence of heart attacks.(15/2)

Patients are becoming more actively involved, more empowered in decision making and more in control in the treatment of their illnesses with complementary and alternative medicines.

Conclusion

Implementation of herbal remedies has been found to be effective throughout South and East Asia for treating cardiovascular and respiratory diseases. Green tea, black tea and oolong tea consumption has shown beneficial effects on cardiovascular health, stroke and respiratory diseases. The compounds in tea are polyphenolic and catechins which have been shown to inhibit oxidation and vascular inflammation. The antioxidant effect which can directly act on immune cells is a factor in cardiovascular and respiratory disease.

Short and long-term black tea consumption has been shown to reverse oxidants with the antioxidants produced by consuming teas containing catechins. This intake of tea decreases cardiovascular and respiratory disease events.

Green tea consumption shows an interpretation that it may be a prevention in the risk of death from pneumonia. Drinking green tea exerts antiviral activities against diseases other than respiratory and cardiovascular, however, tea consumption reduces total stroke incidence, cerebral hemorrhage and cerebral infraction.

There is evidence from epidemiological studies that the habitual consumption of green, black and oolong tea is inversely associated with cardiovascular and stroke mortality and the risk of developing hypertension.

Tea is a safe and inexpensive beverage and consumption should be encouraged. This herbal alternative medicine has a list of successful treatments. A few herbs included in successful alternative remedies are garlic, chamomile, lemon grass, meadowsweet, stinging nettle, magnolias, yew, flaxseed, grape seed, mushrooms, comfrey, calendula and aloe vera.

Writing Services

Essay Writing
Service

Find out how the very best essay writing service can help you accomplish more and achieve higher marks today.

Assignment Writing Service

From complicated assignments to tricky tasks, our experts can tackle virtually any question thrown at them.

Dissertation Writing Service

A dissertation (also known as a thesis or research project) is probably the most important piece of work for any student! From full dissertations to individual chapters, we’re on hand to support you.

Coursework Writing Service

Our expert qualified writers can help you get your coursework right first time, every time.

Dissertation Proposal Service

The first step to completing a dissertation is to create a proposal that talks about what you wish to do. Our experts can design suitable methodologies - perfect to help you get started with a dissertation.

Report Writing
Service

Reports for any audience. Perfectly structured, professionally written, and tailored to suit your exact requirements.

Essay Skeleton Answer Service

If you’re just looking for some help to get started on an essay, our outline service provides you with a perfect essay plan.

Marking & Proofreading Service

Not sure if your work is hitting the mark? Struggling to get feedback from your lecturer? Our premium marking service was created just for you - get the feedback you deserve now.

Exam Revision
Service

Exams can be one of the most stressful experiences you’ll ever have! Revision is key, and we’re here to help. With custom created revision notes and exam answers, you’ll never feel underprepared again.